Health and Wellness Needs for Aging in Place

Age restricted communities often attract residents based on quality of amenities and services, but face challenges related to aging in place, such as planning for the transitions that older age and health problems may necessitate. Older adults may have significant health challenges (Zarit, 1980) which threaten their ability to maintain independence. Various aspects of wellness and aging have been studied, including the importance of health (Farone, et al., 2005; Fesknanish et al., 2005); wellness and leisure activities (Newton & Kemps, 2006; Martin et al., 2006) ; social supports (Liang et al., 2002); and differences by age and gender (He et al., 2005; Fitzpatrick et al., 2005). Few studies, however, have focused on the specific health and wellness needs within an age-restricted planned adult community.

The purpose of this mixed methods study was to determine the perceived health and wellness needs of residents in an age-restricted retirement community in order to examine differences by age, gender, and health status.

Four focus groups with residents (N=80), interviews with key informants (staff and community providers), and a mailed survey to residents (N=805) were used to examine the perceived health and wellness needs of the residents. The findings from the interviews and focus groups were used to determine the key items for survey inclusion.

Participants in the focus groups were recruited through the posting of flyers and use of closed-circuit television and intranet announcements. The survey was mailed to a systematic sample of 1721 residents; 805 responded (48%). Participants ranged in age from 45-102 years; 43% were male and 57% female.

Upon receipt, mailed surveys were coded and scanned. Data analysis software SPSS 16.0 was used. Focus groups were audio recorded and transcribed verbatim, and analyzed according to methods described by Kitzinger (2008).

Focus groups identified salient services such as health monitoring, health education, information and referral, and transition planning needs. Overall satisfaction with the community was linked to these services.

Survey analysis confirmed the focus group findings. As expected, significant differences by age (p<.01) were identified in health and wellness needs and service utilization between the older-old residents (ages 85-102) and younger residents (ages 45-65), using t-tests. Gender differences were not significant. Unmet needs included the importance of transition planning, and psychosocial support. Health conditions, such as wound care, were significantly correlated with increased use of the health and wellness services.

Service delivery and staffing patterns may need to be adjusted according to the needs of older old residents in planned communities. The importance of personalized and accessible care and elimination of redundancy may assist in the sustainability of health and wellness services in retirement communities.

Further research is needed to determine the best mix of services which can meet the needs of the diversity and increase sustainability within seemingly homogeneous, age restricted communities. The difficulty in accessing services which comes with decreased independence may require significant adaptation of service delivery and staffing patterns for older-old adults, including proactive outreach to anticipate transition needs.